Network Contracting Specialist SCA
Network Contracting Specialist SCA
Posted on :
06-04-2025
Employer Active
1 Vacancy
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Job Description
Duties And Responsibilities
- Manages single case agreement (SCA) negotiations with physicians and physician groups in assigned area.
- Prioritizes to ensure all related provider and facility SCAs are executed timely to ensure continuity of care for members.
- Conducting several negotiations simultaneously to meet growth demands.
- Proactively builds relationships that nurture provider partnerships to support the local market strategy.
- Initiates nurtures and maintains effective channels of communication with matrix partners including but not limited to Claims Medical Management. Credentialing Legal Medical Economics Compliance Sales and Marketing.
- Responsible for meeting unit cost targets while preserving an adequate network to achieve and maintain competitive position.
- Identify and manage initiatives that improve total medical cost and quality.
- Prepares analyzes reviews and projects financial impact of high spend or increasingly complex provider contracts and alternate contract terms.
- Assists in resolving elevated provider service complaints. Research problems and negotiate with internal/external partners/customers to resolve complex and/or escalated issues.
- Demonstrates comprehensive knowledge of providers in an assigned geographic area through understanding the interrelationships as well as the competitive landscape.
- Performs other duties as assigned
Position Requirements
- Bachelors degree or equivalent experience in related field plus 3 years of work experience within provider contracting and/or health insurance
- Experience with physician and physician group contracting and negotiations
- Experience in developing and managing key provider relationships including senior executives
- Demonstrated experience in seeking out building and nurturing strong external relationships with provider partners
- Intimate understanding and experience with larger more complex integrated delivery systems managed care and provider business models
- Team player with proven ability to develop strong working relationships within a fastpaced organization
- Strong written and verbal communication skills. Experience with formal presentations
- Customer centric and interpersonal skills are required
- Superior problem solving decisionmaking negotiating skills contract language and financial acumen
- Hybrid/Remote with occasional travel 5
- Existing relationships with physicians and physician groups in Texas is highly recommended
Required Experience:
IC
Employment Type
Full-Time
Key Skills
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